title: Does tranexamic acid in an irrigating fluid reduce intraoperative blood loss in orthognathic surgery? A double-blind, randomized clinical trial.
abstract: OBJECTIVE
  The aim of this study was to investigate the efficacy of tranexamic acid in an irrigant fluid in decreasing intraoperative blood loss during orthognathic surgery.
  
  
  METHODS
  This was a prospective, randomized, double-blind, placebo-controlled trial of elective bimaxillary osteotomy. Forty patients were included in the study and 20 were randomly assigned to each group. Drawing of random lots determined whether 0.05% tranexamic acid in normal saline solution or normal saline was used as an irrigant fluid during surgery. All patients underwent hypotensive anesthesia and surgery according to standard protocol. Intraoperative blood loss, operative and hypotensive times, preoperative and postoperative hematocrit levels, transfusion of blood product, and amount of irrigant fluid were recorded. Parametric data were reported as mean ± standard deviation and nonparametric data were counted. Changes in parametric variables were analyzed using unpaired Student t test. Two-sided significance tests were used. P < .05 was accepted as statistically significant.
  
  
  RESULTS
  Blood loss during bimaxillary surgery was not decreased significantly in the tranexamic acid group compared with the control group (832.5 ± 315.5 vs 917.5 ± 424.0 mL, respectively, P = .47).
  
  
  CONCLUSIONS
  Tranexamic acid in an irrigant fluid does not significantly decrease intraoperative blood loss compared with placebo during orthognathic surgery.
authors.affiliation: Department of Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
authors.forename: Pariya
authors.initials: P
authors.lastname: Kaewpradub
authors.forename: Benjamas
authors.initials: B
authors.lastname: Apipan
authors.forename: Duangdee
authors.initials: D
authors.lastname: Rummasak
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D057909:Orthognathic Surgery; D010027:Osteotomy; D007507:Therapeutic Irrigation; D014148:Tranexamic Acid / Q000008:administration & dosage*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid